tbuckley/cabot-search huggingface dataset:
The effect of known risk factors on the excess mortality of black adults in the United States
Authors: M. W. Otten
Journal: JAMA (1990)

We compared the mortality rate ratios, before and after adjustment for different risk factors, of black vs white adults in the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. For persons 35 to 54 years old, the rate ratio of mortality for blacks vs whites decreased from 2.3 (unadjusted) to 1.9 when adjusted simultaneously for six well-established risk factors (smoking, systolic blood pressure, cholesterol level, body-mass index, alcohol intake, and diabetes) and decreased from 1.9 to 1.4 when adjusted for the six risk factors plus family income. Thus, approximately 31% of the excess mortality can be accounted for by six well-established risk factors and a further 38% by family income. This leaves 31% unexplained. Broader social and health system changes and research targeted at the causes of the mortality gap, coupled with increased efforts aimed at modifiable risk factors, may all be needed for egalitarian goals in health to be realized. (<i>JAMA</i>. 1990;263:845-850)
Medicine 100 years ago. I. JAMA and the competition: 1887
Authors: L. S. King
Journal: JAMA (1987)

IN THE 1880s the aristocrat of medical journals was undoubtedly<i>The American Journal of Medical Sciences</i>(founded in 1827). A quarterly, with about 300 octavo pages per issue, it was easily the most scholarly medical periodical in the United States. The contributors included leading British as well as American physicians and surgeons. Publication was prompt, and there was "liberal compensation for articles used." Each issue had about ten "original communications." Some dealt in depth with clinical conditions, others with various aspects of the preclinical sciences. Much experimental work was included. In a single issue the papers would range from an experimental study of ulcerative endocarditis to pancreatic surgery to a clinical study of cerebral localization. Much of the journal was devoted to long, critical, and analytic book reviews that were usually superbly informative. At least 90 pages per issue were given to a systematic survey of current literature, arranged in
Chronic Pain
Authors: Gerônimo Lluberas-Acosta
Journal: Annals of Internal Medicine (1991)

Letters15 February 1991Chronic PainGerônimo Lluberas-Acosta, MDGerônimo Lluberas-Acosta, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-114-4-342_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors:I read Max's excellent discussion on analgesia (1) in search of suggestions that would help me with the most difficult group of patients in a rheumatology practice. I was disappointed to discover that, as with many other monographs on the subject, it explicitly excludes patients with chronic pain due to serious nonmalignant disease. Severe rheumatoid arthritis, advanced ankylosing spondylitis, and patients who cannot tolerate nonsteroidal anti-inflammatory drugs are but a few examples. Although a body of data about acute pain and chronic cancer pain is emerging, no such data are available to guide clinicians in managing other...References1. Max M. Improving the outcomes of analgesic treatment: is education enough? Ann Intern Med. 1990;113:885-9. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Gerônimo Lluberas-Acosta, MDAffiliations: Marietta Rheumatology Associates, P.C. Marietta, GA 30060 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 February 1991Volume 114, Issue 4Page: 342-343KeywordsAnalgesiaAnkylosing spondylitisDrugsPainRheumatic painRheumatoid arthritisRheumatology ePublished: 1 December 2008 Issue Published: 15 February 1991 PDF downloadLoading ...
Hypovolemic shock
Authors: W. Schumer
Journal: JAMA (1979)

A 65-YEAR-OLD man is admitted to the emergency department with a two-day history of melena associated with dizziness and light-headedness. The skin is pale, cold, and clammy. The radial pulse is thready and small at 130 beats per minute. The patient is dyspneic with a respiratory rate of 24/min, and the blood pressure (BP) is 110/60 mm Hg. As the examination progresses, the patient becomes agitated, and circumoral cyanosis appears. The mucous membranes become dry, the BP decreases to 80/40 mm Hg, and the pulse rate increases to 150 beats per minute. A nasogastric tube is inserted, and it elicits bright red blood. This is a description of hypovolemic or hemorrhagic shock, probably secondary to upper gastrointestinal hemorrhage. Shock is defined as inadequate circulating blood volume with decreasing peripheral vascular perfusion ultimately causing cellular metabolic derangements. The volume loss from a bleeding gastric or duodenal ulcer stimulates pressure receptors in
Abstract 16657: MicroRNA-184 is Epigenetically Silenced by CpG Methylation and Contributes to the Pathogenesis of Arrhythmogenic Cardiomyopathy Phenotype
Authors: Xiaofan Chen, Priyatansh Gurha, Raffaella Lombardi, James T Willerson, Ali J Marian
Journal: Circulation (2015)

Introduction: A phenotypic characteristic of arrhythmogenic cardiomyopathy (AC) is a gradual replacement of cardiac myocytes by fibro-adipocytes, which leads to cardiac arrhythmias, dysfunction and sudden death. Hypothesis: Differentially expressed miRNAs contribute to the pathogenesis of AC Results: Control and plakophilin-2 (PKP2)-suppressed HL-1 myocytes (HL-1Pkp2-shRNA) were screened for the expression of 750 miRNA using Taqman low-density microfluidic panels. Thirty-one miRNAs were up- and 28 were down-regulated in the HL-1Pkp2-shRNA myocytes. MiR-184 was the most down-regulated miRNA (~10-fold). It was also down-regulated in the heart of mouse models of AC. MiR-184 was developmentally regulated in the mouse heart as its levels were the highest in cardiac myocytes islated from the newborn mice, the lowest in adult myocytes and intermediate in myocytes isolated from 3-week old mice. Ingenuity pathway analysis of paired miR-184 and mRNA sequencing data identified cell proliferation, differentiation and death as the major affected functions. Knock down of miR-184 by shRNA reduced cellular proliferation/viability, increased apoptosis, and enhanced adipogenesis. Levels of over a dozen regulators of lipid synthesis were increased along with fat droplets. Over-expression of miR-184 had reciprocal effects. Bisulfite sequencing identified differential hypermethylation of the CpG sites at the upstream region of miR-184. Treatment with 5-aza-2’-deoxycytidine, a demethylation agent, partially rescued suppressed miR-184 levels. However, activation or suppression of the Hippo and the canonical Wnt signaling pathways, implicated in the pathogenesis of AC, did not affect miR-184 levels. Likewise, miR-184 over-expression or suppression did not affect the Hippo and Wnt signaling. Conclusions: miR-184 is developmentally regulated with the highest levels of expression in the newborn myocytes. It levels are suppressed in the AC models, partially because of hypermethylation of the CpG sites at its genomic regions. MiR-184 by regulating cellular proliferation and differentiation contributes to the pathogenesis of AC.
Restrictive Cardiomyopathy
Authors: Sudhir S. Kushwaha, John T. Fallon, Valentin Fuster
Journal: New England Journal of Medicine (1997)

Restrictive cardiomyopathy is defined as heart-muscle disease that results in impaired ventricular filling, with normal or decreased diastolic volume of either or both ventricles. Systolic function usually remains normal, at least early in the disease, and wall thickness may be normal or increased, depending on the underlying cause.1 The condition usually results from increased stiffness of the myocardium that causes pressure within the ventricle (or ventricles) to rise precipitously with only small increases in volume. Since the condition affects either or both ventricles, it may cause symptoms and signs of right or left ventricular failure. Often, right-sided findings predominate, with . . .
The Relationship between Low-Level Benzene Exposure and Leukemia in Canadian Petroleum Distribution Workers
Authors: A. Robert Schnatter, Thomas W. Armstrong, Lorrie S. Thompson, Mark J. Nicolich, Arnold M. Katz, Wendy W. Huebner, Eileen D. Pearlman
Journal: Environmental Health Perspectives (1996)

This study was conducted to evaluate the relationship between leukemia occurrence and longterm, low-level benzene exposures in petroleum distribution workers.Fourteen cases were identified among a previously studied cohort [Schnatter et al., Environ Health Perspect 101 (Suppl 6): 85-99 (1993)].Four controls per case were selected from the same cohort, controlling for birth year and time at risk.Industrial hygienists estimated workplace exposures for benzene, without knowledge of case-control status.Average benzene concentrations ranged from 0.01 to 6.2 ppm.Company medical records were used to abstract information on other potential confounders such as cigarette smoking.Odds ratios were calculated for several exposure metrics.Conditional logistic regression modeling was used to control for potential confounders.The risk of leukemia was not associated with increasing cumulative exposure to benzene for these exposure levels.Duration of benzene exposure was more closely associated with leukemia risk than other exposure metrics, although results were not statistically significant.A family history of cancer and cigarette smoking were the two strongest risk factors for leukemia, with cumulative benzene exposure showing no additional risk when considered in the same models.This study is consistent with other data in that it was unable to demonstrate a relationship between leukemia and long-term, low-level benzene exposures.The power of the study was limited.Thus, further study on benzene exposures in this concentration range are warranted.
Automotive
Authors: Jack Coulehan
Journal: Annals of Internal Medicine (2019)

Ad Libitum5 March 2019AutomotiveJack Coulehan, MDJack Coulehan, MDCenter for Medical Humanities, Compassionate Care, and Bioethics at Stony Brook University, Stony Brook, New York (J.C.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-0312 Audio Reading - “Automotive” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Automotive," by J. Coulehan. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail I must have a fault in my timing beltor a crack in the shaft assembly.What do I know about ingredientsleaking from my tank? I've come to a stop,stalled in the parking lot, burdened byignorance of what that's about.My doctor's an antonym. She sayssecond gear, but I hear reverse.A good mechanic, but innocent,she lacks specs for my sparkplugs—and data for my model year.My doctor offers me a can of polishand stiffens my wipers with advice.She fixes leaks in two of my bald tires. Author, Article, and Disclosure InformationAffiliations: Center for Medical Humanities, Compassionate Care, and Bioethics at Stony Brook University, Stony Brook, New York (J.C.)Current Author Address: Jack Coulehan, MD; e-mail, john.[email protected]edu. PreviousarticleNextarticle Advertisement Audio Reading - “Automotive” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Automotive," by J. Coulehan. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 5 March 2019Volume 170, Issue 5Page: 348 ePublished: 5 March 2019 Issue Published: 5 March 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Comprehensive Electrodiagnosis
Authors: Alex J. Arieff
Journal: JAMA (1962)

DESPITE its complexity, the use of electronics has become fashionable as an aid in establishing diagnoses in various neuromuscular disorders. At the present time electromyography seems to be taking precedence over all other electrodiagnostic methods, even though the older methods are as informative—sometimes even more so—and require simpler apparatus and less technical knowledge. In order to compare the efficacy of these methods, we analyzed the pertinent data accumulated on patients at the Veterans Administration Hospital, Hines, 111. The electrical examination is usually performed by a neurologist assisted by a physical therapist trained in the technique. The physician requesting the electrical evaluation submits a brief clinical summary and the reason for the examination. The complete electrical examination includes stimulation studies of the involved muscle with both galvanic and faradic currents, commonly called electrodiagnosis, and studies of electrical potentials of the muscle in the electromyographic phase of the examination. Conduction velocity studies
DUTY AND POWER OF THE WISCONSIN COUNTY BOARD.
Journal: JAMA (1894)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Abstract 13174: Sex Differences in Clinical Characteristics, Management and Prognosis in Patients With Heart Failure With Preserved Ejection Faction: Insights From the CHART-2 Study
Authors: Kanako Tsuji, Yasuhiko Sakata, Masanobu Miura, Soichiro Tadaki, Ryoichi Ushigome, Takeshi Yamauchi, Kenjiro Sato, Takeo Onose, Ruri Abe, Kotaro Nochioka, Jun Takahashi, Satoshi Miyata, Hiroaki Shimokawa
Journal: Circulation (2015)

Background: The number of the patients with heart failure with preserved ejection fraction (HFpEF) has been rapidly increasing worldwide. However, sex differences in patients with HFpEF remain to be elucidated. Methods and Results: We examined sex differences in 3,124 consecutive patients with HFpEF (EF≥50%, mean 69.4years, 34.7% female) registered in our Chronic Heart Failure Analysis and Registry in the Tohoku District-2 (CHART-2) Study (N=10,219). Female patients, as compared with male patients, were characterized by higher age (72 vs. 68 years, P&lt;0.01), higher LVEF (67 vs. 64%, P&lt;0.01), higher heart rate (74 vs. 70bpm, PNYHA class III (14.1 vs. 7.0%, P&lt;0.01), higher BNP levels (106 vs. 73pg/mL, P&lt;0.01), lower prevalence of coronary artery disease (30 vs. 53%, P&lt;0.01) and lower prescription rates of renin angiotensin system inhibitors (64.7 vs. 71.8%, P&lt;0.01) and beta-blockers (37.8 vs. 43.9%, P&lt;0.01). During the median 3.2-year follow-up, 147 female patients and 245 males died. Although there was no sex difference in all-cause mortality (13.6 vs. 12.0%, P=0.11), female patients more frequently died due to cardiovascular causes (53.7 vs. 39.2%, hazard ratio (HR): 1.62, 95% CI 1.20-2.18, P&lt;0.01), and experienced more HF admissions (12.6 vs. 9.8%, HR: 1.35, 95% CI 1.08-1.68, P&lt;0.01). Use of beta-blockers or renin-angiotensin system inhibitors was not associated with decreased incidence of death or HF admission in both sexes. In contrast, use of statins was associated with reduced incidence of all-cause death in both sexes (males and females; adjusted HR, 0.59 and 0.57; 95% CI 0.46-0.77 and 0.47-0.70, respectively, both P&lt;0.01) and was also associated with reduced incidence of HF admission in males (adjusted HR: 0.67, 95%CI 0.53-0.85, P&lt;0.01) but not in females (adjusted HR: 0.83, 95% CI 0.63-1.10, P=0.19). Conclusions: As compared with males, female patients with HFpEF were characterized by severer condition of HF and increased risk of cardiovascular death and HF admission. Although statin use was equally associated with improved mortality in both sexes, female patients with HFpEF may benefit from statins less than males in terms of reduction of HF admission.
Incorrect Color Reproduction
Authors: T V Rajan, J Clive
Journal: JAMA (2000)

1972 and 1982, and tracked individual funding histories for 25 years and 15 years, respectively.Data consisted of the number of grants each individual received annually following the index year.A total of 1707 individuals received awards in 1972 and 1639 in 1982.Because of the nature of record keeping at the NIH, the precise length of each award was not available.Based on the historical
Paint spray gun injury of the hand. Report of an unusual source of lead poisoning
Authors: R. Lilis
Journal: JAMA (1981)

LEAD poisoning is a well-known occupational hazard in a number of industries and trades.<sup>1-3</sup>While working conditions and health status of employees in industries with well-recognized potential lead hazards are improving, unexpected sources of lead exposure continue to generate disease.<sup>4</sup> We report a clinical case of lead poisoning that occurred as a consequence of an industrial accident— paint spray gun injury to the hand. Such accidents have attracted attention<sup>5-8</sup>for reasons related to the sequelae of the traumatic injury; to our knowledge, this is the first reported case of lead poisoning resulting from such an injury. <h3>Report of a Case</h3> A 41-year-old man, a painter, used a high-pressure paint-spraying gun to apply paint on the hull of a ship. On Jan 10, 1980, the hose of the paint-spraying installation broke, and paint was injected under high pressure into the palm of his left hand. He was first examined
FRACTURES OF THE NECK OF THE FEMUR
Authors: WILLIS C. CAMPBELL
Journal: JAMA (1923)

The principles and routine treatment of fractures of the neck of the femur are so well understood and intelligently carried out by members of this section that it was with much hesitancy that I selected the subject for this occasion; but as the statement has been repeatedly made, during the past year, that bony union does not occur, or that bony union rarely occurs, which is contrary to the opinion of observers worthy of consideration, a careful investigation was instituted to determine the process of repair in central or intracapsular fractures of the neck of the femur. In 1919, in an article<sup>1</sup>on fractures of the neck of the femur, in which 116 cases were analyzed, I stated, concerning twenty-nine central fractures, that twenty-four gave excellent functional results, by which is meant that the patient was able to walk without support, pain or discomfort, and with every evidence of
Abstract 2848: TSPAN8-EPS8L3 signaling play a role in EGF-dependent pancreatic cancer cell invasion and migration
Authors: Junjian Li, Rongxuan Zhu, Gaoda Ju, Weiyu Ge, Mengyi Jiang, Tianhao Zhou, Hongxia Wang
Journal: Cancer Research (2019)

Abstract The mechanism and function of TSPAN8 on the invasion and metastasis of cancer cells is poorly understood. In present study, we demonstrated that TSPAN8 over-expressed in pancreatic cancer (Paca) tissues (37.98%) comparing with normal tissue (0%). TSPAN8 expression levels were reversely correlated with the overall survival time of Paca patients (p = 0.021). In vitro, over-expressed or knockdown TSPAN8 expression in Paca cells SW1990 or Capan-2 and AsPC-1 modulated invasion, immigration and clone formation ability. Mechanistically, we revealed that SOX9, a downstream transcription factor of EGFR signaling, activated TSPAN8 transcription under EGF condition. Meanwhile, we uncovered a previously uncharacterized mechanism underlying EGF-dependent Paca cells invasion and migration. In brief, TSPAN8 was phosphorylated at Ser129 by AKT, resulting in the binding of TSPAN8 with BCAFL1, TSPAN8 entering nucleus and regulating the EPS8L3 transcription, remodeling of cytoskeleton, and enhancing cell invasion and migration. By single cell seq analysis of Paca cells derived from patients and tissue array assay, we validated that the EGFR and EPS8L3 expression in mRNA and protein level were highly correlated with TSPAN8 expression. In vivo and in vitro study demonstrated that EPS8L3 depletion or overexpression rescued the invasion ability induced by TSPAN8. These findings reveal a molecular basis of EGF-TSPAN8-EPS8L3 signaling and highlight the critical role of TSPAN8 in tumor metastasis. Citation Format: Junjian Li, Rongxuan Zhu, Gaoda Ju, Weiyu Ge, Mengyi Jiang, Tianhao Zhou, Hongxia Wang. TSPAN8-EPS8L3 signaling play a role in EGF-dependent pancreatic cancer cell invasion and migration [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2848.
Highlights
Journal: JAMA Internal Medicine (2018)

For this cohort study, Goodwin and colleagues described the association of hospitalist years of experience with 30-day mortality and hospital mortality of their patients by using a sample of national Medicare data of patient and hospital characteristics.Results showed that patients cared for by hospitalists in their first year of practice experience higher mortality, and early-career hospitalists may require additional support to ensure optimal outcomes for their patients.Continuing Medical Education jamanetwork.com/learning Left Ventricular Assist Devices and Renal Disease 204Bansal and colleagues examined the the utilization of and outcomes associated with left ventricular assist devices (LVAD) in nationally representative cohorts of patients with and without end-stage renal disease (ESRD).Results showed that patients with ESRD at the time of LVAD placement had an extremely poor prognosis, with most surviving for less than 3 weeks.This information may be crucial in supporting shared decision-making around treatments for advanced heart failure for patients with ESRD.Thomas and colleagues provide the Invited Commentary.Invited Commentary 210 LESS IS MORE Cardiac Testing vs Clinical Evaluation Alone 212For this secondary analysis, Reinhardt and colleagues examined differences in outcomes with clinical evaluation and noninvasive testing (coronary computed tomographic angiography or stress testing) vs clinical evaluation alone.Results showed that in patients presenting to the emergency department with acute chest pain, negative biomarkers, and a nonischemic electrocardiogram result, noninvasive testing with coronary computed tomographic angiography or stress testing leads to longer length of stay, more downstream testing, more radiation exposure, and greater cost without an improvement in clinical outcomes.Curfman provides the Editor's Note.